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  • Blue Cross Blue Shield Of Michigan Card Alpha And Numeric Subscriber Form

Get Blue Cross Blue Shield Of Michigan Card Alpha And Numeric Subscriber Form

MEMBER APPLICATION FOR PAYMENT CONSIDERATION Fill out online print sign and mail with original receipts to THIS INFORMATION CAN BE TAKEN FROM YOUR BCBSM I. D. CARD MEMBER Alpha SUBSCRIBER S ALPHA/NUMERIC CONTRACT NUMBER Numeric SUBSCRIBER S LAST NAME Medical Benefit BLUE CROSS BLUE SHIELD OF MICHIGAN 27000 WEST 11 MILE ROAD M. D. CARD MEMBER Alpha SUBSCRIBER S ALPHA/NUMERIC CONTRACT NUMBER Numeric SUBSCRIBER S LAST NAME Medical Benefit BLUE CROSS.

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Your Benefit Guide - State of Michigan
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How to access and use Availity Authorizations: Log in to Availity. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations*

Requests for authorization for BCBS Michigan members can be submitted directly through your local Blue plans electronic portal via the Electronic Provider Access system (EPA). BCBSM encourages the use of the Electronic Provider Access system (EPA) to effectively and efficiently respond to your request.

Blue Cross Complete's D. 0 Payer Sheet (PDF) contains Blue Cross Complete's BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and rebilling.

How do providers initiate a prior authorization request? Call 1-877-917-2583 (BLUE) or fax 1-844-407-5293. Hours are 8 a.m. to 7 p.m. Eastern time on weekdays; and 10 a.m. to 5 p.m. on weekends and holidays.

Then, select the Prior Authorization and Notification tool on your Link dashboard. Or, call 888-397-8129.

The home plan can be identified by the [typically] 3 character alpha prefix on the patient's insurance card.

Are Anthem and Blue Cross Blue Shield of Michigan the same company? No, Anthem and Blue Cross Blue Shield of Michigan are two separate companies.

BCBSM requires prior authorization for services or procedures that may be experimental, not always medically necessary, or over utilized. Providers must submit clinical documentation in writing explaining why the proposed procedure or service is medically necessary.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232